Blips, diabetes

Mar 25, 2012

Hi,
I was diagnosed with HIV when admitted to hospital for aids related pneumonia in Oct 2008. My VL was 226,000 and CD4 was 40. I began with atripla in December 2008 and within 3 months VL was below 50 and CD4 had climbed to over 150. I was also told I was borderline type 2 diabetic and put on to 850 mg Metformin each day with elevated cholesterol and put on to 10 mg atorvastatin each day. My adherence has been perfect. My CD was up to 380 in Oct. 2011. My last two tests show a detectable VL of 38 and most recent 83 and a fall in CD4 to 296. My doctor has scheduled another blood test for 6 weeks time and has doubled the metformin dose and quadrupled the statin dose, and has suggested that if the trends are not reversed it may be necesssary to change medication. I have tolerated the atripla very well. Should I be worried?

Response from Dr. Holodniy

Given your prior undetectable viral load levels, I would not be concerned. Although you don't indicate what your CD4 percent is (another good number to follow, as it is more stable over time), I suspect it has not changed significantly over time. Those viral load results are more likely to be insignificant blips and not failure.

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